Devona M. Stalnaker | |
195 W Pike St Suite 203 Lawrenceville GA 30046-4966 | |
(678) 318-1994 | |
(678) 377-6080 |
Full Name | Devona M. Stalnaker |
---|---|
Speciality | Community/behavioral Health |
Location | 195 W Pike St, Lawrenceville, Georgia |
Authorized Official Name and Position | Devona M Stalnaker (OWNER) |
Authorized Official Contact | 6783181994 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Devona M. Stalnaker Po Box 1359 Lawrenceville GA 30046-1359 Ph: (678) 318-1994 | Devona M. Stalnaker 195 W Pike St Suite 203 Lawrenceville GA 30046-4966 Ph: (678) 318-1994 |
NPI Number | 1053671321 |
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Provider Enumeration Date | 05/21/2012 |
Last Update Date | 05/21/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053671321 | NPI | - | NPPES |
12183939 | Other | CAQH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | LPC004683 (Georgia) | Primary |
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